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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
1998-4-15
pubmed:abstractText
Recent studies have shown a considerable increase in the number of aged patients with gastric cancer. In this retrospective study, we report our 18-year experience with 110 patients aged 80 years and over affected with this neoplasm. Postoperative morbidity and mortality rates and risk factors affecting their incidence were examined by univariate and multivariate analysis. Operability and resectability rates were 70.9% and 47.3% respectively. Of the resective procedures, 41 (78.8%) were subtotal gastrectomies. In five cases (9.6%), we performed combined resections. Twenty-five patients (32.1%) experienced postoperative complications; overall mortality rate was 12.8% (10 patients). In resective procedures, morbidity and mortality were 26.9% and 3.8% respectively, which are very low rates compared to other Western reports. Statistical analysis identified the number of preexisting medical illnesses as an independent predictor of morbidity and mortality. Crude five-year survival rate of curatively resected cases was 43%. Although multiple medical illnesses involved much higher operative mortality, neither the presence of postoperative complications nor the number of preexisting medical illnesses significantly influenced five-year survival rate of curatively resected patients. With careful evaluation and selection of patients, correct treatment of concomitant diseases and adequate peri- and postoperative care, gastric surgery provides good immediate and long-term results even in very old patients. Subtotal gastrectomy with limited lymphadenectomy should be the preferred procedure; total gastrectomy, combined resections and extended lymphadenectomy should be performed only when necessary, in patients with fewer than two illnesses. Surgery should be avoided in patients with highly advanced disease, if multiple medical illnesses are present.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Feb
pubmed:issn
0368-2811
pubmed:author
pubmed:issnType
Print
pubmed:volume
28
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
116-22
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed:year
1998
pubmed:articleTitle
Complications after surgery for gastric cancer in patients aged 80 years and over.
pubmed:affiliation
Istituto Policattedra di Scienze Chirurgiche, Second Department of Surgery, University of Siena, Italy.
pubmed:publicationType
Journal Article